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Ann Surg. Nov 1994; 220(5): 601–609.
PMCID: PMC1234447

Randomized phase I/II trial of a macrophage-specific immunomodulator (PGG-glucan) in high-risk surgical patients.


OBJECTIVE: The safety and efficacy of PGG-glucan in surgical patients at high risk for postoperative infection who underwent major thoracic or abdominal surgery were determined. SUMMARY BACKGROUND DATA: Recent studies have reported a 25% to 27% infectious complication rate in patients undergoing major surgery with an average cost per infected patient of $12,000. The efficacy of PGG-glucan pretreatment in prevention of sepsis has been demonstrated in rodent models for gram-negative and gram-positive bacterial and yeast infections. In vitro studies have demonstrated enhanced microbial killing by monocytes and neutrophils in healthy volunteers after PGG-glucan administration. Thus, PGG-glucan may play a role in decreasing the infectious complication rate in patients undergoing major surgery. METHODS: A double-blind, placebo-controlled randomized study was performed in 34 high-risk patients undergoing major abdominal or thoracic surgery. RESULTS: There were no adverse drug experiences associated with PGG-glucan infusion. Patients who received PGG-glucan had significantly fewer infectious complications (3.4 infections per infected patient vs. 1.4 infections per infected patient, p = 0.05), decreased intravenous antibiotic requirement (10.3 days vs. 0.4 days, p = 0.04) and shorter intensive care unit length of stay (3.3 days vs. 0.1 days, p = 0.03). CONCLUSIONS: PGG-glucan is safe and appears to be effective in the further reduction of the morbidity and cost of major surgery.

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Selected References

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  • Shulkin DJ, Kinosian B, Glick H, Glen-Puschett C, Daly J, Eisenberg JM. The economic impact of infections. An analysis of hospital costs and charges in surgical patients with cancer. Arch Surg. 1993 Apr;128(4):449–452. [PubMed]
  • von der Kammer H, Krauhs E, Aumüller G, Scheit KH. Characterization of a monoclonal antibody specific for prostatic secretory protein of 94 amino acids (PSP94) and development of a two-site binding enzyme immunoassay for PSP94. Clin Chim Acta. 1990 Mar 15;187(3):207–219. [PubMed]
  • Janusz MJ, Austen KF, Czop JK. Isolation of soluble yeast beta-glucans that inhibit human monocyte phagocytosis mediated by beta-glucan receptors. J Immunol. 1986 Nov 15;137(10):3270–3276. [PubMed]
  • Daly JM, Lieberman MD, Goldfine J, Shou J, Weintraub F, Rosato EF, Lavin P. Enteral nutrition with supplemental arginine, RNA, and omega-3 fatty acids in patients after operation: immunologic, metabolic, and clinical outcome. Surgery. 1992 Jul;112(1):56–67. [PubMed]
  • Knaus WA, Draper EA, Wagner DP, Zimmerman JE. An evaluation of outcome from intensive care in major medical centers. Ann Intern Med. 1986 Mar;104(3):410–418. [PubMed]
  • Browder W, Williams D, Pretus H, Olivero G, Enrichens F, Mao P, Franchello A. Beneficial effect of enhanced macrophage function in the trauma patient. Ann Surg. 1990 May;211(5):605–613. [PMC free article] [PubMed]
  • de Felippe Júnior J, da Rocha e Silva Júnior M, Maciel FM, Soares A de M, Mendes NF. Infection prevention in patients with severe multiple trauma with the immunomodulator beta 1-3 polyglucose (glucan). Surg Gynecol Obstet. 1993 Oct;177(4):383–388. [PubMed]
  • Czop JK, Puglisi AV, Miorandi DZ, Austen KF. Perturbation of beta-glucan receptors on human neutrophils initiates phagocytosis and leukotriene B4 production. J Immunol. 1988 Nov 1;141(9):3170–3176. [PubMed]
  • Wakefield DS, Helms CM, Massanari RM, Mori M, Pfaller M. Cost of nosocomial infection: relative contributions of laboratory, antibiotic, and per diem costs in serious Staphylococcus aureus infections. Am J Infect Control. 1988 Oct;16(5):185–192. [PubMed]
  • Mellors JW, Kelly JJ, Gusberg RJ, Horwitz SM, Horwitz RI. A simple index to estimate the likelihood of bacterial infection in patients developing fever after abdominal surgery. Am Surg. 1988 Sep;54(9):558–564. [PubMed]
  • Finkler SA. The distinction between cost and charges. Ann Intern Med. 1982 Jan;96(1):102–109. [PubMed]

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